A treatise on the science and practice of midwifery / By W. S. Playfair.
- William Smoult Playfair
- Date:
- 1885
Licence: Public Domain Mark
Credit: A treatise on the science and practice of midwifery / By W. S. Playfair. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![its fellow of the opposite side to form the uterus and Fallopian tubes in the female, and subsequently the central partition at their point of junc- tion disappears. If, however, the progress of development be in any way checked, the central partition may remain. Then we have pro- duced either a complete double uterus or the uterus bicornis, which is bifid at its upper extremity only; or a double vagina, each leading to a j separate uterus. Pregnancy in Cases of Bifid Uterus.—If pregnancy occur in any of these anomalous uteri—and many such cases are recorded—serious troubles may follow. It may happen that one horn of the double uterus is not sufficiently large to admit of pregnancy going on to term, and rupture may occur. It is supposed that some cases, presumed to be tubal gestation, were really thus explicable. Impregnation may also occur in the two cornua at different times, leading to superfoetation. It is, however, quite possible that impregnation may occur in one horn of a bifid uterus, and labor be completed without anything unusual being observed. A remarkable case of this sort has been recorded by Dr. Ross of Brighton,' in which a patient miscarried of twins on July 16, 1870, and on October 31, fifteen weeks later, was delivered of a healthy child. Careful examination showed the existence of a complete double uterus, each side of which had been impregnated. Curiously enough, this patient had formerly given birth to six living children at term, nothing remarkable having been observed in her labors. It can only rarely happen that, under such circumstances, so favorable a result will follow, and more or less difficulty and danger may generally be expected. Occasionally the vagina only is double, the uterus being single. Dr. Matthews Duncan has recorded some cases of this kincP in which the vaginal septum formed an obstacle to the birth of the child, and required division. Lj/mrnenis_of the Uterus.—The various folds of peritoneum which invesrtlieliterus serve to maintain it in position, and they are described as its ligaments. They are the_broad^ the vesico-uterine. and sacro- uterine ligaments; the round ligani£nts are not peritoneal folds like the others. [Within a few years we have had no less than five reports of cases of labor in New York and Philadelphia in which it was claimed that tubal fetal cvsts had discharged their contents through the uterus and vagina. This is certainly not in accordance with what is usually taught and believed in regard to the termination of Fallopian or interstitial preg- nancies. The illustration here introduced is in evidence that a uterus may be duplex and still bear the outward form of a single organ. Cases of this type have Ijeen distinctly recognized during life by Drs. Baer and Drysdale of Philadelphia; and the ])atient of tlic fi)rnier bore twins, whose i)lacenta3 were discharged separately and at an interval of a quarter of an hour. Two of the reports ah'cady I'eferred to are illus- trated by drawings representing a normal uterus and a dilated Fallopian tube. How such a cyst is to discharge its contents other than by the usual way of bursting into the pelvic cavity I cannot compi-chcnd, ])articularly when w(! consider that in what is called interstitial j)regiian(y tlic thickest ' Lunci't, August, 1871. ^ Research en in OljfilctricK, ]>. -l-ll!.](https://iiif.wellcomecollection.org/image/b2121072x_0075.jp2/full/800%2C/0/default.jpg)
